Impact of Chronic HCV Infection on Treatment Outcome of Patients with Non-Hodgkin's Lymphoma

Background: Hepatitis C virus (HCV) is a hepatotropic and potentially lymphotropic virus. Chronic HCV infection might be involved in the pathogenesis of non-Hodgkin’s lymphoma (NHL). Aim: to determine the prevalence of HCV infection in patients with NHL and its effect on treatment outcome. Methods: In this retrospective study, two hundred patients presented with NHL were screened for chronic HCV infection by detecting anti-HCV antibody then further confirmation with real-time polymerase chain reaction for HCV-RNA. We compared treatment response, hepatotoxicity, relapse-free survival (RFS) and overall survival (OS) according to HCV infection (NHL with negative HCV RNA group and NHL with positive HCV RNA group).

Results: Median age was 52 years old. Anti-HCV antibodies were detected in 101 patients (50.5%), and HCV-RNA was detected in 97 patients (48.5%). A curative-intent anthracycline-containing regimen as first-line treatments, with rituximab addition, was given in 68 patients. Hepatic toxicity developed in 45 patients. Eight patients (4%) had to discontinue chemotherapy due to severe hepatic impairment (toxicity grade 3–4). HCV infection was not a significant risk factor for hepatic toxicity. There was no significant difference between patients with chronic HCV infection and those without disease regarding the response to treatment. With a follow-up 12 months for patients with positive antibodies for HCV and those with negative antibodies for HCV, there was no significant difference between two the groups as regards relapse and relapse-free survival. Patients with chronic HCV infection did not have significantly different outcome than those without HCV-infection (P <0.05).

Conclusion: HCV infection might not influence the clinical course in patients with NHL and does not affect the treatment response, patient survival and prognosis of NHL.